Join the four science writers of Ars as they examine the ostensibly scientific …

Over the past couple of weeks, Ars has started receiving e-mails about a topic that doesn't really fit into our normal areas of coverage: homeopathy. The belief that the administration of nothing more than water can have a medicinal affect certainly isn't technology, and it only peripherally touches upon science, in the sense that any health benefits it provides seem to involve the placebo affect.

Nevertheless, many of the practitioners of homeopathy have tried to claim the mantle of science, creating scientific-sounding explanations for "water memory"—the idea that a substance can actually gain potency as it is diluted out of existence. These practitioners even formed a peer-reviewed journal to discuss their findings. Six years ago, the journal Homeopathy ran a special issue on these explanations, and the Ars writers teamed up to tackle the bizarre distortions of science that it contained.

So in honor of World Homeopathy Week (which we just received a press release for), we're going to run an updated version of that story. Not because we think there's a value in talking about homeopathy. Rather, by scientifically evaluating homeopathy's attempts to sound scientific and revealing it to be nothing more than "pseudoscience," we think it's possible to learn something about the scientific process and the reasoning that drives it. In turn, we can possibly learn to recognize other areas where scientific reasoning has ended up on the rocks.

This feature was originally published on September 11, 2007.

Welcome to Waterworld

Welcome to a special edition of Nobel Intent. Beyond keeping you familiar with the comings and goings of modern science, we have consistently expressed concern regarding science education and the public understanding of science. Key to that understanding are the basic features of science, such as how scientific concepts are formulated and tested and why they typically produce a better understanding of the natural world than alternative approaches.

But science can be a tricky thing to define, and it's sometimes easier to contrast it with some of the arguments that pose as science. Unfortunately, most of those issues are entangled with implications that keep the basic question—is this science?—obscured by emotional responses. Thus, the science of climatology has become entwined with political, economic, and policy issues. The science of evolution conflicts with the political and religious goals of some individuals. Even basic scientific questions about the nervous system get embroiled in family and personal health issues when topics like autism and radio frequency radiation are broached.

That's why a special edition of the journal Homeopathy appears to be a gift, allowing us to look at science and psuedoscience without getting entangled with politics and religion. Homeopathy claims to be a form of medical practice that's based on the principle that "like cures like." Given a set of symptoms, a homeopath will identify an herb or chemical that causes similar symptoms. Following a predefined ritual, the homeopath performs a series of dilutions of that chemical that continue well beyond the point where there should be no molecules of it left—the final solution is essentially well-shaken water.

Giving patients water is probably a lot less harmful than many folk remedies that fly under the scientific radar, but homeopathy has two notable distinctions. One is that people spend a lot of money on it—the US market was already close to half a billion dollars in 1999. The second is that homeopaths have demanded that their field be treated as a science, performing clinical studies, proposing mechanisms, and even convincing Elsevier to publish Homeopathy, a peer-reviewed journal.

The articles in this special edition of Homeopathy display a number of consistent themes: internal inconsistency; a rejection of scientific standards and methods; and established science is applied to inappropriate situations (for example, quantum entanglement between people is proposed). In cases where mechanisms are suggested, they frequently violate our basic understanding of the natural world. Tying things together are unsupported assertions and logical leaps that have no place in science. The experience of reading the journal was like seeing a science publication reflected through Alice's looking glass.

By criticizing homeopathy, we hope to illuminate the general distinctions between science and pseudoscience. Hopefully, in finding a topic that's largely free of baggage, we'll help provide a broader picture of what makes science distinct from fields that feign scientific legitimacy.

Suppression of water memory

Most special editions start with an editor's comment; this is no exception. Homeopathy’s editor acknowledges that the most widely held theory for homeopathic action involves the placebo effect. However, he also claims that there is a growing body of evidence for the efficacy of homeopathy, so water memory should be further investigated. He makes a bold claim regarding what the results will be: "There is much work to be done, but at this stage we can say one thing with certainty: the assertion that homeopathy is impossible because the 'memory of water' is impossible is wrong."

The memory of water

Does the rest of this issue bear out this statement? The second article, entitled "The memory of water: an overview,” acts as an introduction. The implication of this title is that we should be able to get a good feel for the state of the field, where it is heading, and what challenges remain.

The author, Martin F. Chaplin, writes with the assumption that the existence of water memory is obvious. But Chaplin never gives a definition of the "water memory effect." As one reads the article, it becomes clear that any behavior of water that is non-obvious is "water memory." This allows Chaplin to present a mix of trivia as if it formed a coherent body of scientific evidence. Oddly, whenever any of these behaviors must be described, Chaplin presents an analogy. We have never seen analogy used in scientific writing as a replacement for a direct, formal argument.

The role of water memory in homeopathy could be demonstrated in two ways: physical measurement of some structure that was imposed upon water by the active ingredient or by the demonstrated efficacy of the diluted solution. Chaplin would, apparently, disagree:

"Editorial comment in the scientific press has subsequently drawn on whether water can indeed show any 'memory' of its prior history as direct 'proof' of whether homeopathy can be successful or not. Such linkage is quite unnecessary and may easily mislead as the two areas utilize fundamentally differing and entirely independent evidence and should therefore be considered separately."

In a certain sense this is true; consistent observations for the efficacy of homeopathy can and would stand alone. However, no such body of evidence appears in this issue, which shifts the burden to evidence for the memory of water. Water memory claims violate several deeply held physical principles that are backed by a great deal of evidence, so proof of the failure of these principles should require solid data. Instead, we are subjected to increasingly wild and far-fetched proposals that, in the absence of direct evidence, must be investigated as a substitute. Chaplin bristles at the fact that these proposals have not been well received by the scientific community, and he suggests that science’s high standards for overturning established principles have "resulted in the slow uptake of new ideas and the overly long retention of fallacious concepts."

Let's consider science's track record in this regard. Quantum mechanics, special, and general relativity spring to mind as examples of radical new ideas. They went from new hypotheses to accepted theories in less than the working lifetime of the scientists involved. RNA splicing and interference were radical at the time yet were quickly accepted on the basis of solid evidence. This should tell you something about both science and this author.

Reading about this crap just now makes me feel slightly unreal and detached from the world.

Not just because I have witnessed someone choosing death without any need by adhering to beliefs in homeopathy and even way more crazy things instead of choosing the >>90% chance of surviving by very minor surgery and a mild chemo for at least the next 5 years.

Not just because I have read books about actual science since I was maybe 12 years old.

But I am just now writing a paper about the philosophy of science about some part of information systems. After reading <insert pretentious philosopher name> and the application to the discipline by <insert less pretentious scientist name> for days straight and then coming to the conclusion that the theoretical underpinnings are lacking in certain areas, reading about something as outright made up as homeopathy really makes me feel like a detached academic.

It reminds me of my plans in the past to get a foot into the esoteric business. All jokes about IBM (or these days Apple) and how they sell dung for the price of gold aside, this is a niche where this actually happens. In some cases literally. One day I will be bitter enough and have forgotten how much I value ethics and start selling my own health scams....And then, instead of upgrading to a Ferrari, put the money towards skeptics organizations...

That's why a special edition of the journal Homeopathy appears to be a gift, allowing us to look at science and pseudoscience without getting entangled with politics and religion.

I don't know if homeopathy is available through American private health insurance, or any public healthcare schemes, but to a very small degree homeopathy is available in the UK through the NHS. This is obviously a politically contentious issue, not least because that idiot Prince Charles believes in it, and when the state provides health care, all health care is political.

Selling a placebo as a "cure" is totally immoral, unethical and possibly unlawful. If your "patient" is unwell, you really need to determine the cause of the illness - and if you know your product doesn't actually treat anything then rather than possibly allowing the condition to worsen you should refer them to a real medical practitioner.

This is not a very encouraging argument, since a result that was almost but not quite statistically significant is, in fact, insignificant.

Definitely not defending the shoddy science here, but it should be worth noting that the line between statistically significant and not significant is rather arbitrary. Most common is the 5% p-value rule, where a result is considered statistically significant when there is a chance less than or equal to 5% that the obtained result was caused by coincidence, chance.

This 5% is a completely arbitrary value, and the actually p-value of an experiment is also greatly dependent on the experimental setup and most importantly the sample size.This p-value also does not inform you of the meaningfulness of the observed effect, another important issue in statistics and often overlooked.

To illustrate: I could, by measuring very precisely, in fact prove that people in city A are on average 0.1 mm taller than those in the neighboring city B, and if my sample sizes are big enough, this result might be highly significant. However the effect size of only 0.1 mm on an average height of 1.80 m is completely pointless.

So, depending on the experimental setup, sample sizes and observed effect, a result that is 'almost statistically significant' might still prove rather important and valid, or it could be utterly pointless. I guess what I'm trying to say here is that statistical significance, on its own, doesn't really say much about the validity of a study.

Obviously, the science behind homeopathy is indeed pseudo, no matter the 'almost significance' of said research.

This is not a very encouraging argument, since a result that was almost but not quite statistically significant is, in fact, insignificant.

Definitely not defending the shoddy science here, but it should be worth noting that the line between statistically significant and not significant is rather arbitrary. Most common is the 5% p-value rule, where a result is considered statistically significant when there is a chance less than or equal to 5% that the obtained result was caused by coincidence, chance.

This 5% is a completely arbitrary value, and the actually p-value of an experiment is also greatly dependent on the experimental setup and most importantly the sample size.This p-value also does not inform you of the meaningfulness of the observed effect, another important issue in statistics and often overlooked.

To illustrate: I could, by measuring very precisely, in fact prove that people in city A are on average 0.1 mm taller than those in the neighboring city B, and if my sample sizes are big enough, this result might be highly significant. However the effect size of only 0.1 mm on an average height of 1.80 m is completely pointless.

So, depending on the experimental setup, sample sizes and observed effect, a result that is 'almost statistically significant' might still prove rather important and valid, or it could be utterly pointless. I guess what I'm trying to say here is that statistical significance, on its own, doesn't really say much about the validity of a study.

Obviously, the science behind homeopathy is indeed pseudo, no matter the 'almost significance' of said research.

On a practical note, would you accept your doctor prescribe you medicine that only had a 5% or less success rate?

I do not dispute this argument, but it is of no relevance to the state of known samples of liquid water, where the history concerns just the sample and is not the sum of the individual memories of all the molecules since the beginning of time

This strawman argument is profoundly stupid. But it is what you would expect from people trying to defend homeopathy with the veneer of Science.

What's more sad is that we let these people do it. Far too many scientists avoid doing anything to actually educate the public. This helps foster the "elitism" claims that others use to denigrate Science. And the mistrust the public has in Science is what allows base charlatans like these people the opportunity to ply their snake-oil.

Quote:

The great weakness of the model is that it is inspired solely by clinical conventions with no direct experimental support.

... So you admit that the only reason you have a model at all is because you need some bullshit technobabble excuse to give people when you try to bilk people out of their money.

No, the great weakness of your model is that it's full of shit.

Quote:

It is important to emphasize that, from the studies so far conducted, we cannot derive reproducible information concerning the influence of the different degrees of homeopathic dilution or the nature of the active principle (solute) on the measured physiochemical parameters.

Then how in the pluperfect hell did you get published? Oh right, the journal of charlatans. Never mind.

Quote:

Moral: If two different observations seem to be mutually incompatible within the frame of an established theory, the most probable explanation is not that one of the observations is wrong, but that the theory is wrong or at least incomplete, and that the observations merely discovered that it was not self-consistent.

Right... so if you think you saw a deceased relative alive and well, then you did. Despite all prior evidence that says that people don't get up and walk around after being dead. No, there's no way you could have been mistaken; you have in fact born witness to an actual resurrection. Don't do anything to confirm this by looking again to see if that shadow you saw in dim light was actually your deceased relative.

Will read the article, but I just want to say that the placebo effect is awesome. I know some people who has dabbled with homeopathy, and while it is BS some people are actually helped by it, by the magic of placebo. If people think their lives are improved, why not let it be so?

Selling a placebo as a "cure" is totally immoral, unethical and possibly unlawful.

Even though placebos have been repeatedly proven to produce a verifiable 'cure' under the correct circumstances? We have to face it - the placebo effect is real, and it doesn't always confine itself to hypochondriac nutters. Unfortunately, one of the (many) placebo factors involves the patient believing that the treamtent is efficacious, so misleading labelling is part of the process.

Placebos aren't going to cure cancer, but there are a variety of other ailments where they play a part. Should we reject this therapy solely from a sense of scientific correctness? Homeopathic remedies are nothing more than tap water in a fancy bottle, but if they 'work' in the sense of making the patient feel well whereas before they felt ill, then how are they unethical?

They desperately want to believe. That's what we should be studying, people who desperately want to believe, to the point of ignoring evidence and making up shit. Homeopathy is just the tip of the ice berg.

This is not a very encouraging argument, since a result that was almost but not quite statistically significant is, in fact, insignificant.

Definitely not defending the shoddy science here, but it should be worth noting that the line between statistically significant and not significant is rather arbitrary. Most common is the 5% p-value rule, where a result is considered statistically significant when there is a chance less than or equal to 5% that the obtained result was caused by coincidence, chance.

This 5% is a completely arbitrary value, and the actually p-value of an experiment is also greatly dependent on the experimental setup and most importantly the sample size.This p-value also does not inform you of the meaningfulness of the observed effect, another important issue in statistics and often overlooked.

To illustrate: I could, by measuring very precisely, in fact prove that people in city A are on average 0.1 mm taller than those in the neighboring city B, and if my sample sizes are big enough, this result might be highly significant. However the effect size of only 0.1 mm on an average height of 1.80 m is completely pointless.

So, depending on the experimental setup, sample sizes and observed effect, a result that is 'almost statistically significant' might still prove rather important and valid, or it could be utterly pointless. I guess what I'm trying to say here is that statistical significance, on its own, doesn't really say much about the validity of a study.

Obviously, the science behind homeopathy is indeed pseudo, no matter the 'almost significance' of said research.

On a practical note, would you accept your doctor prescribe you medicine that only had a 5% or less success rate?

Actually it's the other way around. In clinical trials a medicine is usually tested against a placebo. And when the observed effect of the medicine is higher than that of the placebo and is statistically significant, using the 5% rule, that means that there is only a 5% probability the medicine is in fact not more effective than the placebo, and the observed effect is caused by chance. Conversely, there is 95% probability that the medicine is indeed more effective than the placebo.

On an unrelated note, in many therapies, for example cancer therapy, treatments are routinely administered to patients that, due to genetics, only work on around 30% of said patients.I'm not arguing that conventional medicine is as bad as homeopathy, because for those 30%, the therapy really does help, but rather for better screening and more effective application of treatments for individual patients. The $1000 genome project should really help here.

Only thing I can say about homeopathy is that my 1 year child was suffering from toothache and each time I have given him this homeopathic drug its symptoms went away... immediately.

The same result can be obtained by giving your child a vitamin pill or a true placebo. There is a reason your kids will stop crying when a parent 'kisses it better'. It's the inherent trust that parents will make it better that is one of the purest forms of the placebo effect

Selling a placebo as a "cure" is totally immoral, unethical and possibly unlawful.

Homeopathic remedies are nothing more than tap water in a fancy bottle, but if they 'work' in the sense of making the patient feel well whereas before they felt ill, then how are they unethical?

They displace real medicines, and consume funds from the public.Building on fakery leads to an even larger house of cards.Victimizing the gullible isn't ethical.Fakery attracts victimizers and quacks. You are coaching their "patients" to be further victimized.

Diluting the scientific method makes the science even more powerful! After all, just look at all the cool things that become science now: Noah's Flood, Bigfoot, pyramid power, Atlantis, alien abductions, and telepathy! Any science that has all that cool stuff has to be more powerful than the hum-drum ordinary science which says they're impossible. Who wants science that can't do all that?

Meathim wrote:

Will read the article, but I just want to say that the placebo effect is awesome. I know some people who has dabbled with homeopathy, and while it is BS some people are actually helped by it, by the magic of placebo. If people think their lives are improved, why not let it be so?

Because a lot of research indicates that they aren't actually helped by it, but have convinced themselves that they're helped by it. It probably doesn't reduce any objective symptoms of disease or injury measurable by a third party, just their perception by the patient. It can improve their own personal outlook without improving the prognosis at all.

charleski wrote:

Postulator wrote:

Selling a placebo as a "cure" is totally immoral, unethical and possibly unlawful.

Even though placebos have been repeatedly proven to produce a verifiable 'cure' under the correct circumstances?

Except that they haven't, really.

Quote:

Placebos aren't going to cure cancer, but there are a variety of other ailments where they play a part.

They can only do as much as, perhaps, convincing people that they're in less pain than they otherwise would be if not taking a placebo. Even that effect is highly dependent upon the individual patient and isn't really a reliable outcome.

Geez, I should go measure the diffusion properties of water to check this out. Oh wait, it has already been done like 15,000 times not counting the everyday use in MRI and fMRI neither of which would work if water had memory (correlation time) of longer than a nanosecond (it is actually a couple picoseconds).

Selling a placebo as a "cure" is totally immoral, unethical and possibly unlawful.

Why? The goal is to make the person healthy with the minimum of side effects, right? When the problem is psychological and minor in nature, placebos are almost always effective and have no side effects. And that's why somewhere between 50% and 100% of doctors commonly prescribe them:

The reason the vast majority of drugs fail their double-blind tests is not because they don't work. It's because *they don't work better than a placebo*. Some people confuse this, thinking it means that the drug does nothing. Au contraire, the reality is that placebos are provably effective for all sorts of illnesses.

So again, if you have a "drug" that provably improves people's health and has absolutely no side effects, you think that's a bad idea to give it to people?

Wheels Of Confusion wrote:

They can only do as much as, perhaps, convincing people that they're in less pain than they otherwise would be if not taking a placebo.

Absolutely incorrect. A gold-standard study includes *three* groups, active, placebo and control. That's because the placebo group with have *measurable* changes in physiology. I think you need to read up a little more on this.

In fact, placebos are not just effective, but *getting more effective*. What, you find that hard to believe?

"The fact that taking a faux drug can powerfully improve some people's health—the so-called placebo effect—has long been considered an embarrassment to the serious practice of pharmacology."

Now wait, that's not really what I'm saying, that just says the effect is strong. Ahh, but here's the kicker…

"Two comprehensive analyses of antidepressant trials have uncovered a dramatic increase in placebo response since the 1980s"

Actually many similar follow-ups have demonstrated this effect as well. Drugs that easily passed muster in the previous decades now fail to show any difference compared to placebo. The drugs haven't changed. The testing hasn't changed. The placebo effect has changed.

The placebo effect is significant as it uncovers the importance of the relationship between patient and caretaker.

Practicing homeopaths do specifically intense research through dialog with a patient surrounding symptoms and possible origins of his illness. The intimate and respectful treatment is something, at least we here in Germany won´t really get too much from our doctors - as our medicare doesn´t pay for it. It considers talking unnecessary side effects of administering medication and physical treatment. And that´s why more and more patients resort to an institution, which treats them with respect - and not just a mass of flesh entering the medical repairshops.

The But regarding thousands of years of medical history, the relationship between sufferer and healer stood in the forefront, only more or less recently the chirurgical and chemical parts of it took the lead, pushing the so called "witchcrafts" and "voodoo doctors" aside.

Homeopathy´s science certainly is bullshit, but its sociopsychological implication is not at all.

Marry the science of medicine with the psychology of humans, and you would have the best of both worlds. Sometimes science is not the solution, but part of the problem. And sometimes, it is not. That´s why we still are humans, not androids.

Will read the article, but I just want to say that the placebo effect is awesome. I know some people who has dabbled with homeopathy, and while it is BS some people are actually helped by it, by the magic of placebo. If people think their lives are improved, why not let it be so?

Because a lot of research indicates that they aren't actually helped by it, but have convinced themselves that they're helped by it. It probably doesn't reduce any objective symptoms of disease or injury measurable by a third party, just their perception by the patient. It can improve their own personal outlook without improving the prognosis at all.

Quote:

Placebos aren't going to cure cancer, but there are a variety of other ailments where they play a part.

They can only do as much as, perhaps, convincing people that they're in less pain than they otherwise would be if not taking a placebo. Even that effect is highly dependent upon the individual patient and isn't really a reliable outcome.

Traditional medicine can also be pretty unreliable, as in different things work for different people (depending on the ailment of course). Is there a difference between feeling less pain and being in less pain? If I feel less depressed, am I not? Most of the symptoms helped by placebos (depression, anxiety, pain and others) can't be measured as such anyway, they all rely on the patients perception.

Placebo is a thing, and it's a good thing. The problem (as the authors finish) is that some replace actual doctoring with homeopathy, and that is not a good thing.

Homeopathy that "works" as a placebo is fine, so long as (a it does not mask a more serious ailment and (b does not cause further harm. Beyond that, I wouldn't trust any "home remedy" that hasn't been actually shown to do something and I wouldn't trust it for anything serious. Some of that stuff might genuinely work but until someone can prove it, I remain skeptical. This water stuff though? That's pure, undiluted homeopathic snake oil.

Edit: I felt I should clarify that I am most definitely not a believer in homeopathy although it can sometimes by accident stumble onto something valid, I still wouldn't trust it beyond treating a headache.